Biceps Tenodesis for the Treatment of Type II Superior Labral Anterior Posterior (SLAP) Tears in Overhead Athletes Under the Age of 35: A Case Series.

Background: The best treatment for type II superior labral anterior posterior (SLAP) tears in overhead athletes is not well defined.

Questions/purpose: The purpose of this study was to examine post-surgical outcomes in overhead athletes under the age of 35 who underwent primary biceps tenodesis for an isolated type II SLAP tear. We hypothesized that these patients would have high rates of return to play, as well as recovery of range of motion (ROM) and strength after surgery.

Patients And Methods:  Patients were between the ages of 18 and 35, had a primary isolated type II SLAP tear confirmed on magnetic resonance imaging (MRI), and were injured performing overhead activities. All patients underwent biceps tenodesis using an arthroscopic suprapectoral approach. Patients underwent standard postoperative rehabilitation lasting up to one year. Function and outcomes were measured at baseline, three months, six months, one year, and two years using range of motion, strength testing, and patient-reported outcomes (PROs) (Western Ontario Shoulder Instability Index (WOSI), Kerlan-Jobe Orthopedic Clinic Score (KJOC), American Shoulder and Elbow Surgeons Assessment Form (ASES), and Single Assessment Numeric Evaluation (SANE)).

Results:  Five patients were included in the case series. There was consistent improvement at each time point on PROs: WOSI, p=0.01; KJOC, p=0.04; SANE, p=0.02; and ASES, p=0.03. Range of motion increased from baseline to each time point with a significant improvement in forward flexion (p=0.03). In strength testing, there were improvements in all exercises and a significant improvement in abducted external rotation between years 1 and 2 (p<0.01).

Conclusions:  This study demonstrated that biceps tenodesis in overhead athletes under the age of 35 provides improved outcomes, ROM, and strength.